Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Consent To Treatment
  • Schedule For Additional Services
  • HIPAA Compliance Consent Form
  • HIPAA  Notice Of Privacy Practices
  • Missed Appointments and Cancellation
  • Psychosocial Assessment
  • Registration Form
  • ROI Form
  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

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Crossroads Counseling Services TN

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